My father is rapidly deteriorating after transfer from hospital to rehab facility.

“ Rapid decline “ , Dad may need hospice care , or a long term care nursing home on palliative care . He can not go home again , Mom can’t take care of him . Have you spoken to him on the phone ? Has he said why he’s not eating ?
Do your parents have POA papers ?
Have you tried to call the case manager ?

And Mom may not be safe to drive or live at home alone either . She may need supervision in assisted living .

I’m sorry about the situation .

I would contact the rehab and ask if there is a more appropriate place they can recommend for dad to be moved to, and soon. A home health company can supply an aide to stay with him, but I’m not sure will get much in terms of advocacy. My dad had repeated cycles of hospitalization with CHF followed by rehab, each less effective than the last. His walking declined dramatically in his last couple of years. The final rehab was considered a failure to progress, and it was then his doctors recommended he be allowed to choose home hospice, which he did. Not to be negative, CHF is relentless and this might be what your dad is approaching. If I had it do over, I’d likely choose a hospice agency that has an inpatient hospice house for the final weeks or days. I wish you and your dad peace

Sounds like your father needs hospice care now. They will help you find the appropriate facility for him until he passes.
Hospice will not let him suffer and will keep him pain free and comfortable until he dies. And all their care is covered 100% under your fathers Medicare.
You can call the hospice agency yourself, or have your fathers doctor call for you.
Best wishes.

It sound to me like your father will need to be in a LTC facility vs. a rehab facility. If he was in the hospital for a long period of time he most likely lost muscle mass and could have bone issues as well, so most rehabs are not going to be able to help him with this. Unless he was able to go to a more upscale rehab that would do water work to help the muscles come back slowly, he will need LTC. I would not force him to eat if he does not want to but to they can help keep him hydrated. Is there any chance this is a hospice case?

Delia, Hi and welcome to the Forum.
Your mother should no longer be in charge of this, and your father should now be placed in care. Your mother and he could likely, if he can recover enough, enter into ALF together. They would manage his medications.

I do not know how familiar you are with CHF, but the words Congestive HEART FAILURE say it all. His heart is now a failing pump. There is nothing to be done to cure this and he will require diuretics to manage the fluid build up in his lungs and his lower extremities. These diuretics will work for some time, but dependent on the severity of his failure he could go into what is called Flash Pulmonary Edema and could be unable to breath very quickly.

Our bodies age and wear out. We are fine machines, but complicated machines and as I always teased when a nurse, spare parts get harder to get. I think that the plan going forward is crucial now and you have access to discharge planning through the rehab. They will be able to tell you how self-caring Dad can be or cannot be. They can recommend and in fact can help with placement and that's much easier from hospital or rehab than from home.

I wish you good luck and hope you will write us with further questions as they come up.
As you will know, these diuretics cause incontinence and great urgency. They also wash out important electrolytes and the blood must be measured for sodium and potassium with some frequency.

I do not know your parents wishes and you do not tell us but it is time now to discuss the possibility of palliative or hospice care if dad wishes it. It is also time to make certain all paper work is in order.

Years ago I worked for a companion care company, we often went to , nursing homes, hospitals ect.. to give them better care, or because the families worried less if someone was there. It wasn't unusual at all.

So sorry about your dad, it's a very difficult time I'm sure.